PIKEVILLE, Ky. – Carrie Cinnamond realized just how much times have changed when she had a steel vault hauled into her pharmacy in eastern Kentucky.

Two break-ins in two weeks by burglars in search of painkillers forced her to adopt many of the same security measures that are used at the bank down the street.

Ever since prescription painkillers such as OxyContin became the drugs of choice among dealers and addicts in Appalachia, the days of small-town pharmacists dispensing medicines from behind an ordinary counter have become a quaint memory.

Now, many pharmacies have turned into virtual fortresses. Some now have bars over the windows. The most sought-after drugs are stored in vaults. The pharmacists often work behind safety glass, and some have even armed themselves. Surveillance cameras and alarm systems monitor every spot.

Pharmaceutical companies have also adopted practices from the banking industry, delivering prescription pills in armored trucks protected by armed guards and tracked by satellites on carefully chosen routes.

“We feel very strongly that we have a commitment to protect the public and to make sure these drugs are available for people who need them,” said Aaron Graham, vice president of corporate security at Purdue Pharma, the Connecticut-based manufacturer of OxyContin.

“You do that by making sure they’re not stolen or diverted,” Graham said. “Armored vehicles are just one part of the protocol. We use space-age technology involving global positioning to make sure we know where our product is all the time.”

For Cinnamond, the popularity of OxyContin forced her to take extra measures. Burglars broke into her pharmacy twice in 2001, and tried unsuccessfully a third time after she upgraded security.

“It was appalling to me that they could come into the store, take the drugs, go directly to the street, and who knows who they would be selling them to,” Cinnamond said.

Graham, a former Drug Enforcement Administration agent whose Purdue Pharma team advises pharmacies on security, said most drugstores have taken measures to protect against thefts.

“Certainly, there are still some soft targets out there,” he said “But the prudent pharmacist knows he’s got an expensive, valuable commodity that needs to be protected.”

Dan Smoot, chief detective for the eastern Kentucky anti-drug task force Operation UNITE, said prescription drugs remain the top problem for police agencies in the mountains. Smoot led the largest drug raid in Kentucky history two months ago, arresting more than 200 people on charges of buying or selling prescription drugs on the black market.

Smoot said the roundup was aimed primarily at people dealing in OxyContin, a narcotic that can provide 12 hours of relief for cancer patients and others suffering from severe pain. The tablet can produce a quick and potentially lethal high if it is chewed, snorted or injected. It has been linked to more than 100 deaths and bears the government’s strongest warning label.